Head trauma complicated with primary cranial vault lymphoma

Abstract

Rationale: Primary cranial vault lymphoma (PCVL) is an extremely rare extranodal lymphoma in the skull. This case study investigates the clinical features, so as to improve the understanding of the diagnosis and therapy. Patient concerns: A 31-year-old male presented painful scalp mass at the site of 1-month-old head trauma. Diagnosis: The final diagnosis was plasma cell lymphoma, which is a rare subtype of diffuse large B-cell lymphoma based on biopsy and immunohistochemistry findings. Interventions: The patient received total tumor resection in combination with chemotherapy Outcomes: The patient survived without signs of systemic dissemination for 12 months after surgery at the time of last follow-up. Lessons: Trauma may be one of the factors that induce PCVL. The final diagnosis of PCVL depends on pathology and immunohistochemistry findings. A combined treatment of surgery, chemotherapy, and radiotherapy can achieve favorable outcomes.

Primary Cranial Vault Lymphoma Extending between Subcutaneous Tissue and Brain Parenchyma without Skull Destruction after Mild Head Trauma: A Case Report and Literature Review

“…A literature search identified reports of a total of 63 cases of PCVL [ 1 , 2 , 3 , 4 , 5 , 7 , 8 , 9 , 10 ]. In those 63 cases, PCVL arose predominantly in the parietal and frontal vaults of the head (24 parietal and 19 frontal) in middle-aged and elderly people.…”

“…In those 63 cases, PCVL arose predominantly in the parietal and frontal vaults of the head (24 parietal and 19 frontal) in middle-aged and elderly people. The male-to-female ratio showed a slight female predominance (24 men/39 women), and most cases were diffuse large B-cell lymphoma (41/63 cases) [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ]. Thirteen of 63 cases (20.6%) had PCVL invading the brain parenchyma [ 1 , 2 , 3 , 4 , 5 , 7 , 8 , 9 ].…”

“…The male-to-female ratio showed a slight female predominance (24 men/39 women), and most cases were diffuse large B-cell lymphoma (41/63 cases) [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ]. Thirteen of 63 cases (20.6%) had PCVL invading the brain parenchyma [ 1 , 2 , 3 , 4 , 5 , 7 , 8 , 9 ]. Since PCVL involving the dura mater and skull resembles meningioma and metastatic brain tumor, a diagnosis based on imaging findings is frequently difficult.…”

“…In a report of CT findings in 39 cases of PCVL, 74% of the cases showed osteolytic changes, and 5% showed osteoclastic changes, whereas only 18% of the cases showed no bony changes [ 1 ]. In the literature, 11 of 13 cases whose PCVL invaded the brain parenchyma were documented to show osteolytic changes in the skull [ 1 , 2 , 3 , 4 , 5 , 7 , 8 , 9 ]. PCVL in the present case showed rare invasive features without significant changes on imaging and histological findings in the skull, despite extending across the subcutaneous tissue to the brain parenchyma.…”

“…PCVL extends from the subcutaneous tissue to the dura mater and may even invade into the brain parenchyma [ 1 , 2 ]. Furthermore, PCVL has been reported to arise extremely rarely in the site corresponding to past head trauma [ 3 , 4 , 5 , 6 ]. A rare case of PCVL that sandwiched apparently normal skull between subcutaneous and intracerebral lesions after mild head trauma is presented along with a review of the literature.…”